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A source for healthcare professionals to access the latest data and information on the diagnosis, treatment and management of patients with gut related disorders
Watson L et al. Clin Med (Lond) 2015;15:536–540.
Simple low–fat dietary interventions can result in clinically important improvements in gastrointestinal (GI) symptoms due to bile acid malabsorption (BAM) according to the results of this UK study.
Forty patients (20 male and 20 female) with a mean age of 61 years were recruited to the study. These patients had a 7-day tauroselcholic (75selenium) acid (SeHCAT) scan result of <20%. Bile acid sequestrant was administered and optimised in 25 of these patients prior to any dietary changes.
Patients completed a 7-day dietary diary before consultation with a dietitian and rated their GI symptoms using a 10-point numerical scale (NRS-10). Patients then followed a tailored, low-fat diet, which aimed to provide 20% of total energy from fat for 6–8 weeks following which their GI symptoms were reassessed.
There was a significant reduction in urgency, bloating, lack of control and bowel frequency (p≤0.01). The median symptom rating for flatulence, abdominal pain, greasy/pale stool and abdominal gurgling was also reduced (p≤0.05). Mean dietary fat intake reduced from 62.3 g to 42.2 g after intervention (p≤0.01). Mean dietary fibre intake was similar before and after intervention (14.8 g vs 14.4 g, p=not significant).
Since BAM is the cause of the GI symptoms in around half a million patients treated for diarrhoea-predominant IBS (IBS-D) by the NHS, simple dietary intervention to lower fat intake has the potential to have a widely beneficial effect.
Job number: JB57410GBu Date of Preparation: June 2019
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Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease
In patients with Crohn’s disease who had a prior surgical resection there was a modest correlation between the length of ileal resection and the severity of bile acid malabsorption (BAM), as defined by tauroselcholic (75selenium) acid (SeHCAT) retention values. Response to bile salt sequestrant therapy was not dependent on SeHCAT retention values.
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